​In its latest guidance to skilled nursing facilities (SNFs), the American Health Care Association (AHCA) on Friday issued interim guidance to assist SNFs as they make decisions about accepting hospital discharges during the COVID-19 pandemic.

AHCA said “the decision making and guidance will likely change as the prevalence of COVID-19 varies in communities and hospital surge increases in the community.”

The guidance is meant to help reduce the risk of admitting an individual with COVID-19 into a facility. The document also offers providers steps to follow to prevent any virus spread.

During the COVID-19 pandemic, the elderly will still need medical care that requires hospitalization and post-acute care. But, the volume of some traditional post-acute admission is decreasing as hospitals discontinue most elective surgeries and elective admissions.

However, hospitals foresee a surge in admissions related to COVID-19, who will need post-acute care, especially as the virus affects more and more people.

AHCA noted that the Centers for Medicare & Medicaid Services (CMS) has also waived the three-day stay requirement for all discharges, regardless of COVID-19 status, to allow hospitals to more easily create new beds for the surge in COVID-19 admissions.

This means SNFs will face the challenge as to which hospital discharges they can accept. The decision-making process will vary depending on if the SNF has COVID-19 positive residents already, the prevalence of COVID-19 in the surrounding community, and the hospital’s capacity, as well as the ability of the SNF to manage residents who are COVID-19 positive or suspected to have COVID-19, AHCA said.

Further, the association strongly urged SNFs to start now in creating separate wings, units, or floors by relocating current residents to handle admissions from the hospital and keep these current residents separate, if possible. “It is likely state public health officials may issue state- or regional-specific guidance that supersedes this guidance,” AHCA said.

AHCA said if a resident requires IV fluids, oxygen, and other treatments due to their respiratory symptoms, Medicare will allow a provider to switch the person over to Medicare Part A without a three-day SNF stay. “Discussion with families and residents should occur about the risks of hospitalization with COVID-19 during this pandemic period,” the association said.